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DRS BROCK, HENDERSON, DI PRISCO, RAVELO AND GREEN INC
NPI 1235546813
Dentist - Oral and Maxillofacial Surgery in Beckley, WV

Active since July 16, 2014
150 BROOKSHIRE LN, BECKLEY, WV 25801(304) 345-1092(304) 345-5080 Get Directions Write a Review

NPPES record last updated: May 29, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 29, 2025, Dec 3, 2020, Jun 15, 2018 and 1 more (4 updates tracked since 2016).

About Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DRS BROCK, HENDERSON, DI PRISCO, RAVELO AND GREEN INC (NPI 1235546813) is a healthcare organization registered as an oral and maxillofacial surgery in Beckley, West Virginia and active in the NPI registry since July 2014. The organization lists Lesley Marie Coyner, Credentialing, as its authorized official.

NPPES Registry Identity

NPI1235546813
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameDRS BROCK, HENDERSON, DI PRISCO, RAVELO AND GREEN INC
Location Address150 BROOKSHIRE LNBeckley, WV 25801
Mailing Address103 Station Place WayHurricane, WV 25526-8747 · (304) 720-7819 · Fax (304) 345-5080
Phone(304) 345-1092
Fax(304) 345-5080
Organization SubpartNo
Authorized OfficialLesley Marie CoynerCredentialing · (304) 345-1092
Enumeration DateJuly 16, 2014
Last NPPES UpdateMay 29, 20254 updates tracked since enumeration
NPPES CertifiedMay 29, 2025
✔ NPI 1235546813 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
150 BROOKSHIRE LN, Beckley, WV 25801
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Highmark Blue Cross Blue Shield West Virginia.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

12

Medicare enrollment records show 12 clinicians reassign Medicare billing to Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (12)

Kenny Nguyen, DDS
Oral Surgery
NPI 1528637378
4307 MACCORKLE AVE SE
Charleston, WV 25304
(304) 720-7819
✔ PECOS✔ Accepts Medicare45 mi
James Henderson, M.D./DDS
Oral Surgery
NPI 1295799963
415 MORRIS ST SUITE 309
Charleston, WV 25301
(304) 388-3290
✔ PECOS47 mi
Jose Ravelo, DDS
Oral Surgery
NPI 1457693020
869 OAKWOOD RD
Charleston, WV 25314
(304) 345-1092
✔ PECOS48 mi
John Green, DDS FACS
Oral Surgery
NPI 1770892705
895 E WASHINGTON AVE
Vinton, VA 24179
(540) 344-7252
✔ PECOS78 mi
Brandi Lantz, DDS
Oral Surgery
NPI 1538804828
417 GRAND PARK DR STE 103
Parkersburg, WV 26105
(304) 699-5010
✔ PECOS✔ Accepts Medicare108 mi
Timothy Bartholomew, DDS
Oral Surgery
NPI 1306077656
630 LEXINGTON AVE
Mansfield, OH 44907
(419) 756-0711
✔ PECOS218 mi
Peter Dorf, DMD
Oral Surgery
NPI 1174178263
9225 DOERR RD
Ft Belvoir, VA 22060
(922) 512-2022
✔ PECOS227 mi
John Mclaughlin, DDS
Oral Surgery
NPI 1649200783
14346 WARWICK BLVD
Newport News, VA 23602
(757) 755-8771
✔ PECOS✔ Accepts Medicare258 mi
Ryane Staples, DMD
Oral Surgery
NPI 1750906814
NAVAL MEDICAL CENTER PORTSMOUTH 620 JOHN PAUL JONES CIRCLE
Portsmouth, VA 23708
(757) 953-2711
✔ PECOS275 mi
Kyle Lee, DDS
Oral Surgery
NPI 1306299565
620 JOHN PAUL JONES CIR
Portsmouth, VA 23708
(757) 953-2730
✔ PECOS✔ Accepts Medicare275 mi
Enrique Schubert, DDS
Oral Surgery
NPI 1447791454
1611 NW 12TH AVE
Miami, FL 33136
(305) 585-5326
✔ PECOS827 mi
Italo Di Prisco, D.D.S
Oral Surgery
NPI 1871807875
51SW 11TH ST. APT 1034
Miami, FL 33130
(786) 219-6497
✔ PECOS829 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc's NPI number?

The NPI number for Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc is 1235546813. It was assigned to this organization in the NPPES registry on July 16, 2014.

Where is Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc located?

Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc is located at 150 Brookshire Ln, Beckley, WV 25801. The listed phone number is (304) 345-1092.

What is Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc enrolled in Medicare?

Yes. Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 12 clinicians, all in Oral Surgery, reassign their Medicare billing to Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc accept?

Health plans from Highmark Blue Cross Blue Shield West Virginia list Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc was last updated on May 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.